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2 DIABETES AND HEART DISEASE Diabetes raises your risk of getting heart disease by 2 to 4 times. You can lower that risk if you follow a healthy lifestyle plan. What is a healthy lifestyle plan? It begins with keeping your diabetes in control and being aware of your diet and exercise. It also means knowing your blood fat levels and lowering other risk factors. Everyone should have a healthy lifestyle plan, but it is really key for people with diabetes. HELPFUL DEFINITIONS: Lipids blood fats Cholesterol a waxy, fat-like substance made by the liver that helps your cells function. Your body makes some cholesterol, and you also get it in the food you eat. LDL (low-density lipoprotein) known as the bad cholesterol because it sticks to the walls of your blood vessels. HDL (high-density lipoprotein) known as the good cholesterol because it carries away the sticky (LDL) cholesterol. Triglycerides another kind of fat in your blood. Levels can go up after eating a high fat meal. Lipid Profile a series of lab tests including LDL, HDL and triglycerides.

3 WHAT ARE THE RISK FACTORS FOR HEART DISEASE? There are many risk factors for heart disease. These include: Age: men over 45 years old women over 55 years old Family history of heart disease Smoking High blood pressure Low HDL High LDL High Triglycerides High Cholesterol Little or no daily exercise Diabetes The more risk factors you have, the greater your risk. Since you can t control some of these factors, it helps to change what you can control, like lowering your cholesterol. Talk to your healthcare team about your risk. HOW DO I LOWER MY CHOLESTEROL LEVELS? Your healthcare team can help you come up with a healthy lifestyle plan. This chart will give you an idea of what your team looks for, and what they might recommend. Type of blood fat Best result Risk goes up when levels are: Cholesterol Less than 200 mg/dl HIGH LDL (bad cholesterol) Less than 100 mg/dl if you have diabetes HIGH HDL (good cholesterol) More than 40 mg/dl (Men) 50 mg/dl (Women) LOW Triglycerides Less than 150 mg/dl HIGH

4 WHAT TO DO TO LOWER YOUR RISK: Cholesterol Eat less saturated fat and less cholesterol LDL Eat less saturated fat and less cholesterol Maintain a healthy weight Take medication (if prescribed) HDL Exercise regularly Stop smoking Maintain a healthy weight Triglycerides Cut down on alcohol Exercise regularly Maintain a healthy weight Eat fewer simple sugars Eat less saturated fat Take medication (if prescribed) Keep your blood sugar under control WHAT S WRONG WITH A LITTLE FAT? Nothing. But Americans tend to get a lot more than a little. Fats are part of a healthy diet. However, fats are very high in calories. In fact, one gram of fat has 9 calories, whereas carbohydrate food like a plain potato (no butter!) has only 4 calories per gram. We all know that eating too much fat will make you put on weight. That s why only about 30% of your total daily calories should come from fat.

5 WHAT ARE THE DIFFERENCES BETWEEN DIFFERENT KINDS OF FAT? Not all fats are created equal. In fact, some fats are better for you than others. Dietary fats, found in foods, can raise LDL & Total cholesterol when eaten in large amounts. The following list describes the different kinds of fat in food, from good to bad. Monounsaturated fats found in vegetables and plants (olive, canola and peanut). These are liquid at room temperature. These have no significant effect on cholesterol. Polyunsaturated fats found in vegetable or plant oils (sunflower, safflower, corn, soybean, sesame and cottonseed) as well as in fish. These are also liquid at room temperature. They tend to lower LDL a little. Saturated fats found in foods of animal origin (meat, dairy products), and tropical oils (palm, coconut, and cocoa butter). These are solid at room temperature. Saturated fats raise LDL & Total cholesterol, and should make up no more than 10% of your total calories. Trans fats or Hydrogenated fats poly or monounsaturated fats that are changed to act like saturated fats (margarine, shortening). They are used in baked goods (cookies, pie, pastry) and fast foods. These have been made solid at room temperature. They raise cholesterol (like saturated fat does).

6 HOW CAN I AVOID TOO MUCH FAT IN MY DIET? To cut down on fat and cholesterol in your diet, try these tips: Broil, bake, steam, barbeque (grill) or microwave rather than fry Season with herbs and lemon juice rather than butter or margarine Choose fat-free or low-fat dairy products Choose lean cuts of meat trim off the fat Avoid bacon, sausage and fatty lunch meats Remove the skin from chicken and turkey Choose fresh vegetables avoid sauces and butter Choose fat-free or low-fat salad dressing Use half of the fat that a recipe calls for Limit creamy sauces (toppings) ask for them on the side Limit fast food ARE THERE ANY FOODS THAT CAN HELP? Foods that are high in fiber can help lower cholesterol and control your weight. There are two kinds of fiber, soluble and insoluble. Soluble fiber dissolves in water, and is found in beans, barley, and some fruits and vegetables. It may help to lower high blood cholesterol levels and keep blood sugar levels under control. Insoluble fiber does not dissolve in water, and is found in wheat bran, whole grains, and vegetables.

7 Insoluble fiber helps digestion. This fiber holds onto water, and helps keep you regular and helps prevent constipation. A high-fiber, low-fat diet may help reduce the risk of some types of cancer. Both kinds of fiber are part of a healthy diet make sure you get enough. Eat 5 or more servings of fresh vegetables and fruits a day Choose raw vegetables and whole fresh fruit with the skin Choose whole grain breads, oatmeal and brown rice Eat low-salt beans, peas and lentils instead of red meat a few days a week WHAT ELSE CAN I DO? Make healthy choices. Eat balanced meals Become more active Check your blood sugar Take your medicines as directed Visit your healthcare team Take time to relax See a diabetes educator or attend a diabetes program/support group Learn more about diabetes and your health (see our Bayer Health Facts brochures on Take Charge of Your Diabetes, Over-the-Counter Drugs, Blood Sugar Testing, Ketone Testing, and A1C Testing also available on-line at BayerDiabetes.com/US)

8 Having diabetes raises the risk for heart disease. You already make healthy choices to control your diabetes. Many of these choices can also help lower your risk of heart disease. Eating properly, staying active, and working with your healthcare team will go a long way in keeping you healthy. Just remember the power to manage your diabetes is in your hands. For more information about Diabetes Care Systems and support from Bayer, or help with your diabetes testing supplies, call our toll-free Customer Service Help Line at (24 hours, 7 days a week). You can also visit our web site at: For more help in managing your diabetes, see a diabetes educator. To find an educator: Bayer HealthCare LLC, Diabetes Care, Tarrytown, NY Rev. 4/07

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